Tailored One Anastomosis Gastric Bypass: 3-Year Outcomes of 94 Patients

Abstract

Background: One anastomosis gastric bypass (OAGB) claims its place among bariatric operations, proving itself a safe and effective procedure.

Methods: This is a retrospective analysis of prospectively collected data regarding 94 patients who underwent surgery in a single surgical unit. Tailoring of the biliopancreatic limb length decided upon preoperative BMI was applied. Patients' excess weight loss and resolution of comorbidities were evaluated. Data on patients' nutritional status is also presented.

Results: Mean BMI reduction at 36 months postoperatively was 21.7 ± 6.3 kg/m². Mean excess weight loss (%EWL) was 83.6%, 91.8%, and 92.5% at 12, 24, and 36 months postoperatively, respectively. When controlling for preoperative BMI, a 36-month %EWL of 89.1% for the 2-m subgroup, a 95.3% for the 2.5-m subgroup, and a 104.7% for the 3-m subgroup were found. Operation's success, defined as %EWL greater than 50%, was 97.9% 36 months postoperatively. All patients suffering from hypertension, diabetes, and dyslipidemia achieved full remission. Furthermore, the percentage of patients with obstructive sleep apnea and gastroesophageal reflux disease, achieving full remission was 91.7% and 86.7%, respectively. An incidence of 5.3% new onset regurgitation was noted. Iron deficiency presented in 26 (27.7%) patients postoperatively, vitamin B₁₂ deficiency in 13 (13.8%), folic acid deficiency in 18 (19.1%), and mild hypoalbuminemia in 7 (7.4%). Major early postoperative complications (Clavien-Dindo grade ≥ 3) were reported in 1.7% of our patients. One (1.1%) patient developed marginal ulcer and two (2.2) patients had late dumping.

Conclusions: OAGB is a safe and efficient technique; however, careful selection of patients and postoperative surveillance with respect to weight regain and nutritional deficiencies are mandatory for optimal results.

Keywords: Bariatric surgery; Comorbidities after OAGB; EWL after OAGB; Metabolic surgery; OAGB effectiveness; OAGB results; One anastomosis gastric bypass (OAGB); Tailoring OAGB.